JP2018099240A - Image processing device, aspiration determination method, and x-ray fluoroscopic device - Google Patents

Abstract

PROBLEM TO BE SOLVED: To detect a risk of aspiration in a contrast examination of deglutition using an X-ray fluoroscopic image.SOLUTION: An aspiration determination device 109 is added to an X-ray fluoroscopic device, and a branch area where the trachea and the esophagus in an X-ray fluoroscopic image are branched is designated by its aspiration determination part 220. A risk of aspiration is determined by calculating how examination food is separated to the trachea and the esophagus in the branch area. The X-ray fluoroscopic image is displayed in a display part 230, and the risk of aspiration is displayed in an aspiration display part 240.SELECTED DRAWING: Figure 3

Description

  The present invention relates to an image processing technique for automatically detecting that aspiration is likely to occur using an X-ray fluoroscopic image when performing a swallowing contrast examination with an X-ray fluoroscopic imaging apparatus.

  Swallowing may not be performed correctly due to aging, and aspiration may occur during eating. Elderly people may develop pneumonia because food traps remain in the bronchi due to aspiration and bacteria grow. In an aging society in the future, swallowing contrast examinations tend to increase in order to determine the degree of dysphagia and rehabilitation. Since this test observes where food is actually swallowed, aspiration may occur, so it is important to detect that aspiration is likely to occur.

  Conventionally, a swallowing contrast examination is performed, and aspiration is visually determined using an X-ray fluoroscopic image, or an accelerometer, a microphone, or the like is attached to the throat to confirm that aspiration has occurred. For example, an accelerometer is attached to the patient's neck, an electronic signal representing swallowing activity is received, features are extracted from the signal, and it is determined whether swallowing activity or aspiration (patent document) 1). Also, a microphone for collecting swallowing sound is attached to the neck, and it is determined whether or not swallowing activity is abnormal based on the waveform (see Patent Document 2).

Special table 2008-502386 JP 2003-111748 A

  However, in Patent Documents 1 and 2, since it is necessary to attach an instrument to a patient, it is troublesome for the patient, and it may be difficult for a child to perform a swallowing contrast examination. Furthermore, after an aspiration has occurred, it is informed that the aspiration has occurred. In addition, at the time of swallowing contrast examination, the examiner visually determines aspiration using a fluoroscopic image, and the movement speed of the test food is fast, and there is a risk of overlooking that aspiration is likely to occur. there were.

  An object of the present invention is to provide an image processing apparatus, an aspiration determination method, and an X-ray fluoroscopic apparatus capable of automatically detecting and notifying that an aspiration is likely to occur by solving the above problems. There is.

  In order to achieve the above object, according to the present invention, there is provided an image processing apparatus for processing an X-ray fluoroscopic image, an area specifying unit for specifying a branch area where the trachea and the esophagus branch in the X-ray fluoroscopic image, A moving region extracting unit that extracts a moving region of a test meal using a fluoroscopic image of the region, and a branching point detecting unit that detects a branching point of the test food based on the moving region, are connected to the branch point. Provided is an image processing apparatus that determines that aspiration due to a test meal is likely to occur using a moving region.

In order to achieve the above object, according to the present invention, there is provided an aspiration determination method by an image processing apparatus for processing a fluoroscopic image, wherein a branch region where a trachea and an esophagus are branched is specified in the fluoroscopic image. ,
An aspiration determination that extracts the moving area of the test meal in the branch area, detects the branch point of the test meal based on the moving area, and determines that the aspiration due to the test meal is likely to occur using the moving area connected to the branch point Provide a method.

  Furthermore, in order to achieve the above object, according to the present invention, there is provided an X-ray fluoroscopic apparatus that captures and processes X-ray fluoroscopic images, an X-ray irradiation unit that irradiates a subject with X-rays, An X-ray detector that detects X-rays transmitted through a person and outputs an X-ray signal, an image processing unit that processes the X-ray signal and generates an X-ray image, and an X-ray image display unit that displays the X-ray image An aspiration determination device that determines that aspiration is likely to occur in a subject using an X-ray image, and the aspiration determination device branches the trachea and esophagus of the subject in the X-ray image An area designating unit for designating a branch area to be performed, a moving area extracting unit for extracting a moving area of the test meal using an X-ray image of the designated branch area, and a branch point of the test meal based on the extracted moving area A branch point detection unit for detecting the distance, and a distance determination unit for determining the distance between the branch point and the end point on the trachea side of the moving region, For example, aspiration by the inspection diet to provide an X-ray fluoroscopic apparatus for detecting that likely to occur with the distance.

  When carrying out a swallowing contrast examination, it is possible to prevent aspiration beforehand by detecting that aspiration is likely to occur automatically using a fluoroscopic image, and a safer examination can be carried out.

It is a figure which shows the X-ray fluoroscopic image around the trachea and esophagus when aspiration occurs. It is a block diagram which shows the whole X-ray fluoroscopic apparatus which concerns on each Example. It is a block diagram which shows one structural example of the aspiration determination apparatus which concerns on Example 1. FIG. 3 is a functional block diagram of an aspiration determining unit according to Embodiment 1. FIG. It is a figure which shows the whole flowchart of the aspiration determination apparatus which concerns on Example 1. FIG. It is a figure which shows the flowchart of the aspiration determination part of Example 1. FIG. It is explanatory drawing of the method of calculating the movement area | region of a test meal from the X-ray fluoroscopic image which concerns on Example 1. FIG. It is explanatory drawing of the branch point detection part which detects the branch point of the test meal which concerns on Example 1. FIG. It is explanatory drawing of the process of the distance determination part which concerns on Example 1. FIG. It is a functional block diagram of the aspiration determination part of Example 3. It is a figure which shows the flowchart of the aspiration determination part of Example 3. It is explanatory drawing of the process which absorbs a subject's motion of Example 3. FIG. FIG. 10 is a diagram illustrating a flowchart of an alignment unit according to a fourth embodiment. It is explanatory drawing of the correction process of the movement amount of the pixel between frames. FIG. 10 is a diagram illustrating an overall flowchart of a fifth embodiment.

  Hereinafter, various embodiments of the present invention will be described with reference to the drawings. FIG. 1 is a diagram showing an X-ray fluoroscopic image for explaining aspiration determination according to the present invention, and FIG. 2 is a diagram showing an overall configuration example of an X-ray fluoroscopic apparatus according to the present invention.

  First, the principle of aspiration determination according to the present invention will be described with reference to FIG. As shown in FIG. 1 (a), the branch region 3 where the trachea 1 and the esophagus 2 branch is specified based on the designation of the examiner in the fluoroscopic image, and as shown in FIG. 1 (b), By calculating the degree of separation between the trachea 1 and the esophagus 2 of the test meal 4 which is food mixed with contrast medium in the branch region 3, it is detected that aspiration is likely to occur, and aspiration is likely to occur Let them know.

  The X-ray fluoroscopic apparatus shown in FIG. 2 sets a top plate 110 on which the subject 101 is placed, an X-ray source 102 that irradiates the subject 101 with X-rays, and an X-ray irradiation area for the subject 101. An aperture device 111, a high voltage generator 105 that supplies power to the X-ray source 102, and an X-ray detector 103 that is disposed at a position facing the X-ray source 102 and detects X-rays transmitted through the subject 101. And an image processing unit 104 that performs image processing on the X-ray signal output from the X-ray detector 103, and an X that displays an X-ray image (including a fluoroscopic image) output from the image processing unit 104. An aspiration is generated from the X-ray fluoroscopic image output from the line image display unit 106, the control unit 107 that controls each of the above components, the operation unit 108 that instructs the control unit 107, and the image processing unit 104. Aspiration determination device for detecting what is likely to occur And a 09.

  Among these, the X-ray image display unit 106, the control unit 107, the operation unit 108, and the aspiration determination device 109 are a central processing unit (CPU), an input unit, a display unit, and a memory of one personal computer (PC). You may comprise using a part.

  The X-ray source 102 has an X-ray tube that receives power supply from the high voltage generator 105 and generates X-rays. The X-ray source 102 may include an X-ray filter that selectively transmits X-rays having specific energy. The diaphragm 111 has a plurality of X-ray shielding lead plates that shield X-rays generated from the X-ray source 102, and each of the plurality of X-ray shielding lead plates moves, so that X-rays to the subject 101 can be obtained. Determine the irradiation area. The X-ray detector 103 is configured by, for example, a plurality of detection elements that detect X-rays arranged in a two-dimensional array, and is irradiated with X-rays from the X-ray source 102 and transmitted through the subject 101. It is a device that detects an X-ray signal according to the amount of incident light.

  The image processing unit 104 performs image processing on the X-ray signal output from the X-ray detection unit 103 and outputs an X-ray image subjected to image processing. Image processing includes gamma conversion, gradation conversion processing, image enlargement / reduction, and the like. The X-ray image display unit 106 displays the X-ray image output from the image processing unit 104 and the subject information / imaging conditions. Moreover, the aspiration determination apparatus 109 detects that aspiration is likely to occur from an X-ray image that is an X-ray fluoroscopic image output from the image processing unit 104 as described in the following embodiments.

  Example 1 is the above-described aspiration determination apparatus, that is, an image processing apparatus that processes an X-ray fluoroscopic image, an area specifying unit that specifies a branch area where the trachea and the esophagus branch in the X-ray fluoroscopic image, and a branch A moving region extracting unit that extracts a moving region of a test meal using a fluoroscopic image of the region, and a branching point detecting unit that detects a branching point of the test food based on the moving region, are connected to the branch point. It is an Example of the image processing apparatus which detects that the aspiration by a test meal is likely to generate | occur | produce using a movement area | region. In addition, the aspiration determination method by the image processing apparatus that processes the fluoroscopic image is to specify a branch region where the trachea and the esophagus branch in the fluoroscopic image, and extract the moving region of the test meal in the branch region. An example of an aspiration determination method for detecting a branch point of a test meal based on a moving region and determining that aspiration due to the test meal is likely to occur using the moving region connected to the branch point, and further using the method 1 is an example of an X-ray fluoroscopic apparatus.

  FIG. 3 is a block diagram illustrating a configuration example of the aspiration determining apparatus of the fluoroscopic imaging apparatus according to the first embodiment. The imaging apparatus 200 in the figure corresponds to a component that captures an X-ray image in the right half of FIG. 2, that is, an X-ray fluoroscopic image. The aspiration determining apparatus 109 records that the X-ray fluoroscopic image sent from the imaging apparatus 200 is recorded, and that the X-ray fluoroscopic image recorded in the recording unit 210 is likely to cause aspiration in real time. It is determined that aspiration is likely to occur in the aspiration determining unit 220 for determining, the display unit 230 for displaying the X-ray fluoroscopic image stored in the recording unit 210 and the X-ray fluoroscopic image being recorded, and the aspiration determining unit 220 In this case, the aspiration display unit 240 notifies the examiner.

  The aspiration determining unit 220 can be configured, for example, by executing a program of a CPU that implements the aspiration determining apparatus 109. Preferably, this CPU uses a CPU separate from the CPU constituting the control unit 107, but the same CPU may be used. The display unit 230 is configured by a display separate from the X-ray image display unit 106 of FIG. The aspiration display unit 240 performs notification and warning display, and can be configured as one display area in the display screen of the display constituting the display unit 230.

  Subsequently, the operation function of the aspiration determination unit 220 of the present embodiment will be described using the functional blocks of FIG. As described above, when the aspiration determining unit 220 is realized by executing a program of the CPU, each functional block can be configured by a program that executes each function. First, the area designating unit 221 is input according to the area around the branch point of the trachea 1 and the esophagus 2 under fluoroscopy under examination and the orientation of the subject's face, which is input by the examiner using the operation unit 108 or the like. Designate the branch area 3.

  The movement area extraction unit 223 extracts the movement area of the test meal 4 in the branch area 3 designated by the area designation unit 221. Subsequently, the branch point detection unit 224 detects the branch point of the test meal from the movement region extracted by the movement region extraction unit 223. Then, the distance determination unit 225 calculates the distance from the branch point of the test meal detected by the branch point detection unit 224 to the end point on the trachea side of the moving region connected to the branch point, so that aspiration is likely to occur. Is detected.

  Next, an overall operation flow of the X-ray fluoroscopic apparatus according to the first embodiment will be described with reference to FIG. The apparatus is activated at step 310 in the figure, and the aspiration determination apparatus 109 starts recording at step 320 and records it in the recording unit 210. In step 330, the region designation unit 221 follows the region near the branch point of the trachea and esophagus that is input from the operation unit 108 by the examiner at an arbitrary timing from the real-time fluoroscopic image recorded in the recording unit 210. A rectangular branch region 3 is designated.

  In the next step 340, based on the movement area of the test meal in the branch area 3 designated in step 330, it is detected that the test meal has branched, and it is automatically determined that aspiration is likely to occur. In step 350, if it is determined in step 340 that aspiration is likely to occur, the fact that aspiration is likely to occur is displayed on the aspiration display unit 240. If it is determined in step 360 that aspiration has not occurred, aspiration is detected. The display indicating that aspiration is likely to occur from the display unit 240 is turned off. In step 370, the test is terminated, and the aspiration determination apparatus is terminated.

  Next, steps 330 and 340 executed by the aspiration determining unit 220 in the overall operation flow described above with reference to FIG. 6 will be described. As described above, the aspiration determining unit 220 can execute steps 330 and 340 by executing a program of the CPU. Step 405 in the figure is the same as step 330 in FIG. In step 410, the latest frame of the fluoroscopic image is read. The X-ray fluoroscopic image is taken at 30 fps (frame / second), for example. In step 415 and step 420, the moving area of the test meal in the branch area 3 designated in step 405 is extracted.

Steps 415 and 420 will be described with reference to FIG. The X-ray fluoroscopic images of the branch regions 3 of the current frame f _t , the previous frame f _t−1 , and the _second previous frame f _t−2 are schematically shown on the left side of FIG. In step 415, the luminance difference between the current frame _ft and the previous frame _ft-1 is taken and binarized with a predetermined threshold value to obtain a binary image of the luminance difference. However, this alone will also extract the area before the movement. Therefore, in step 420, the binarized image 5 of the luminance difference between the frames _ft and _{ft-1 and} the frame between the previous frame _ft-1 and the previous frame _ft-2 are displayed. The common part (AND) of the difference in luminance with the binarized image 6 is extracted, and the moving area 7 is extracted. Thereby, the movement region 7 of the test meal can be extracted.

  Subsequently, at step 425 and step 430, the branch point of the test meal is detected. Steps 425 and 430 will be described with reference to FIG. In step 425, the moving area 7 extracted in step 420 is thinned to obtain a moving area thin line 8. In step 430, the branch 9 of the test meal is detected using the moving region thin line 8. As a condition for the branch point, for example, as shown in an enlarged portion in FIG. However, if the number of black pixels below the branch point is one or less, it is not set as a branch point. The present invention is not limited to this branch point condition, and other appropriate conditions may be set. In step 435, the number of pixels from the branch point 9 to the end point of the moving region thin line 8 connected in the direction in which the subject's face is facing is calculated as a counting distance.

  The method of calculating the distance will be described with reference to FIG. 9 exemplifying the case where the subject is facing left. In step 440, it is determined whether the distance from the branch point 9 to the end points 10 and 11 exceeds the threshold as shown in FIG. This is because when thinning is performed, a branch that should not remain is often left and is removed. If the threshold value is equal to or greater than the threshold value as shown at the end point 11 in FIG. 5B, aspiration is likely to occur. On the other hand, if it is less than the threshold value as shown at the end point 10 in FIG. In step 445, the aspiration display unit 240 informs the examiner that aspiration is likely to occur. In step 450, it is determined whether it is the last frame. If it is the last frame, the process ends. If it is not the last frame, the process proceeds to the next frame.

  Since the configuration of the present embodiment described above can automatically detect that aspiration is likely to occur, aspiration can be prevented in advance, and a safer swallowing imaging test using an X-ray fluoroscopic apparatus can be performed. It becomes possible. Furthermore, since it is automatically detected and notified that aspiration is likely to occur during the examination, the examiner does not always have to be aware of the aspiration and view the fluoroscopic image, thereby reducing the burden on the examiner. be able to.

  Subsequently, an image processing apparatus, an aspiration determination method, and an X-ray fluoroscopic apparatus according to the second embodiment will be described. The difference from the first embodiment is that the aspiration display unit 240 is not used to display that aspiration is likely to occur, but it is possible to make a sound notification using a speaker or the like.

  According to the present embodiment, when the aspiration determination device is applied to the X-ray fluoroscopic image under examination, the inspector can display the display unit during the examination by notifying a sound such as a speaker that aspiration is likely to occur. It is possible to know that aspiration is likely to occur without viewing the video displayed on the screen, and to concentrate on examinations other than aspiration. In this specification, the display unit 230, the aspiration display unit 240, a speaker, and the like may be collectively referred to as an output unit. In other words, the device according to the present invention includes an output unit that displays or informs by sound that aspiration due to a test meal is likely to occur.

  Next, in the third embodiment, the movement of pixels between the current frame and the previous frame in the branch area specified by the area specifying unit is calculated from the optical flow, and the positions of the current frame and the previous frame are calculated. It is an Example of the structure provided with the position alignment part which performs alignment, and is demonstrated below using FIGS. 10-12.

  FIG. 10 is a block diagram of a configuration example of the aspiration determination apparatus according to the third embodiment. The difference from the first and second embodiments is that an aspiration determining unit 220 is added with an alignment unit 222 that absorbs the movement of the subject and aligns the position of the frame.

  The operation of the aspiration determination unit 220 according to the third embodiment will be described with reference to FIG. The difference from the first embodiment and the second embodiment is that a step 411 and a step 414, which are processes of the alignment unit 222, are added between the step 410 and the step 415. These steps are also an aspiration determination unit. This can be realized by executing a program of 220 CPUs.

Steps 411 and 414 will be described with reference to FIG. In the figure, it is assumed that it has moved to the right. In step 411, as shown in FIG. 12, an optical indicating the motion between frames for each pixel using the optical flow method from the two images 12 and 13 of the current frame _ft and the previous frame _ft−1. The flow 14 is calculated. Shifting the image of the frame f _t based on the motion between frames for each pixel at step 414, to obtain an image 15 of the frame f _t after absorbing the subject motion.

  With the configuration of this embodiment, the subject's movement may be included in the difference image between frames due to swallowing movement during swallowing contrast examination or the subject's movement, or the trachea and esophagus from the designated area designated as the branch area It is possible to prevent the branching area from coming off. As a result, a more accurate moving region can be calculated, so that erroneous detection of detection that aspiration is likely to occur can be reduced.

  Subsequently, as the fourth embodiment, the alignment unit described in the third embodiment is configured to correct the motion of the pixel, which is the most frequent optical flow in the pixel of interest and its surrounding pixels, as the motion of the pixel of interest between frames. Examples will be described. Hereinafter, the image processing apparatus, the aspiration determination method, and the X-ray fluoroscopic apparatus according to the fourth embodiment will be described with reference to FIGS. 13 to 14.

  In FIG. 13, an example of operation | movement of the position alignment part 222 of the aspiration determination part 220 of Example 4 is shown. The first embodiment is different from the third embodiment in that a step 413 for correcting the motion between frames is added between the step 411 and the step 414 of the alignment unit.

  Step 413 will be described with reference to FIG. In the same figure, it is assumed that it moved rightward like FIG. In step 414, the abnormal optical flow 16 shown in FIG. 14 is corrected with the most frequent optical flow in the pixel of interest and its surrounding pixels as the movement of the pixel of interest between normal frames, and the optical flow 17 after correction is obtained. . Thereby, the abnormal value of the movement amount of the pixel between frames can be reduced. Therefore, since it is possible to accurately align the designated area designated as the branch area, it is possible to reduce erroneous detection of detection that aspiration is likely to occur. Needless to say, step 414 can also be realized by executing the program of the CPU of the aspiration determining unit 220.

  According to the present embodiment, it is possible to more accurately align the designated area designated as the branch area by correcting the amount of movement of the pixel between frames, so that erroneous detection of detection that aspiration is likely to occur is detected. Can be reduced.

  Next, as a fifth embodiment, a recording unit that records an X-ray fluoroscopic image is further provided, and the X region specifying unit, the moving region extracting unit, and the branching point detecting unit process the X-ray fluoroscopic image read from the recording unit. Embodiments of the image processing apparatus, the aspiration determination method, and the X-ray fluoroscopic apparatus configured as described above will be described. The difference from the first to fourth embodiments is that the read X-ray fluoroscopic image is different, and the aspiration determination is performed on the moving image stored in the recording unit 210.

  The overall operation of the configuration of the fifth embodiment will be described with reference to FIG. In step 710, the aspiration determination device 109 is activated, and in step 720, the recorded data of the recording unit 210 is reproduced. In step 730, the examiner inputs the face direction and the area near the branch point of the trachea and esophagus at an arbitrary timing from the X-ray fluoroscopic image being reproduced, and the area designating unit 221 determines a rectangular branch area based on that. specify. In the next step 740, a moving region is extracted from the branch region specified in step 730, and it is detected using this that the test meal has branched, and it is automatically determined that aspiration is likely to occur. In step 750, if aspiration is likely to occur in step 740, a notification that aspiration is likely to occur is displayed on the aspiration display unit 240 or a sound is notified and in step 760, it is determined that aspiration has not occurred. Then, the display that the aspiration is likely to occur is deleted from the aspiration display unit 240 or the notification warning by sound is stopped. In step 770, the reproduction of the moving image is terminated and the apparatus is terminated.

  According to the present embodiment, it is possible to omit the review of the video recorded many times during the diagnosis of aspiration, and to reduce the burden on the examiner.

  In addition, this invention is not limited to an above-described Example, Various modifications are included. The above-described embodiments have been described in detail for better understanding of the present invention, and are not necessarily limited to those having all the configurations described above. For example, the region designation unit of the aspiration determination unit performed the designation by the examiner using the operation unit etc., the region near the branch point of the trachea and esophagus, and the branch region using the face direction, etc. Image processing of the X-ray fluoroscopic image may automatically detect the region near the branch point and the orientation of the subject's face. Further, a part of the configuration of one embodiment can be replaced with the configuration of another embodiment, and the configuration of another embodiment can be added to the configuration of one embodiment. Further, it is possible to add, delete, and replace other configurations for a part of the configuration of each embodiment.

  Further, the above-described configuration, function, control unit, and the like have been described with reference to an example of creating a program for a CPU that realizes part or all of them. Needless to say, it may be realized by hardware. That is, all or a part of the functions of the control unit may be realized by an integrated circuit such as ASIC (Application Specific Integrated Circuit) or FPGA (Field Programmable Gate Array).

DESCRIPTION OF SYMBOLS 1 Trachea 2 Esophagus 3 Branch area 4 Test meal 5, 6 Binary image 7 Movement area 8 Movement area thin line 9 Branch point 10, 11 End point 12, 13, 15 Image 14, 16, 17 Optical flow 101 Subject 102 X Radiation source 103 X-ray detector 104 Image processing unit 105 High-voltage generator 106 X-ray image display unit 107 Control unit 108 Operation unit 109 Aspiration determination device 110 Top plate 111 Aperture device 200 Imaging device 210 Recording unit 220 Aspiration determination unit 221 Area designation section 222 Position alignment section 223 Moving area extraction section 224 Branch point extraction section 225 Distance determination section 230 Display section 240 Aspiration display section

Claims (15)

An image processing apparatus that processes a fluoroscopic image of a subject,
An area designating unit for designating a branch area where the trachea and the esophagus branch in the fluoroscopic image;
Using the X-ray fluoroscopic image of the branch area, a moving area extracting unit that extracts a moving area of the test meal;
A branch point detector for detecting a branch point of the test meal based on the moving region;
An aspiration determining unit that determines that aspiration due to the test meal is likely to occur, using the moving region connected to the branch point;
An image processing apparatus. The image processing apparatus according to claim 1,
A distance determination unit that determines the distance from the branch point to the end point of the moving region on the trachea side,
The aspiration determining unit determines that aspiration due to the test meal is likely to occur when the distance has exceeded a predetermined threshold.
An image processing apparatus. The image processing apparatus according to claim 1,
An output unit for displaying that the aspiration due to the test meal is likely to occur or notifying by sound is further provided,
An image processing apparatus. The image processing apparatus according to claim 1,
The area specifying unit is
Specify the branch region using the face direction of the subject input by the examiner and the region where the trachea and the esophagus branch,
An image processing apparatus. The image processing apparatus according to claim 1,
A recording unit for recording the X-ray fluoroscopic image;
The region designating unit, the moving region extracting unit, and the branch point detecting unit target the X-ray fluoroscopic image read from the recording unit,
An image processing apparatus. The image processing apparatus according to claim 1,
The moving region extraction unit includes:
The inter-frame difference of the luminance value in the branch area of the current frame of the X-ray fluoroscopic image, the previous frame, and the previous frame is calculated, and the moving area is calculated using the inter-frame difference. Extract,
An image processing apparatus. The image processing apparatus according to claim 6,
The branch point detector
Thinning the moving area to obtain a moving area thin line,
The distance determination unit sets the distance from the branch point to the end point of the moving region thin line on the trachea side as the distance.
An image processing apparatus. The image processing apparatus according to claim 6,
The movement of the pixel between the current frame and the previous frame in the branch area specified by the area specifying unit is calculated from an optical flow, and the alignment of the current frame and the previous frame is performed. An alignment unit for performing further,
An image processing apparatus. The image processing apparatus according to claim 8,
The alignment unit is
Correcting the movement of the pixel as the movement of the pixel of interest between frames of the pixel of interest and the surrounding pixels most frequently,
An image processing apparatus. An aspiration determination method by an image processing apparatus that processes a fluoroscopic image,
Specify the branch region where the trachea and esophagus branch in the fluoroscopic image,
Extracting a movement area of the test meal in the branch area, detecting a branch point of the test meal based on the movement area, and using the movement area connected to the branch point, aspiration due to the test meal is likely to occur Determine
An aspiration determination method characterized by the above. The aspiration determination method according to claim 10,
Determining the distance from the branch point to the end point of the moving region on the trachea side, and when the distance exceeds a predetermined threshold, determine that aspiration due to the test meal is likely to occur,
An aspiration determination method characterized by the above. The aspiration determination method according to claim 11,
The inter-frame difference of the luminance value in the branch area of the current frame of the X-ray fluoroscopic image, the previous frame, and the previous frame is calculated, and the moving area is calculated using the inter-frame difference. Extract and
Thinning the moving area to obtain a moving area thin line,
The length from the branch point to the end point of the moving region fine line on the trachea side is the distance.
An aspiration determination method characterized by the above. An X-ray fluoroscopic apparatus that captures and processes X-ray fluoroscopic images,
An X-ray irradiation unit for irradiating the subject with X-rays;
An X-ray detector that detects X-rays transmitted through the subject and outputs an X-ray signal;
An image processing unit that processes the X-ray signal and generates an X-ray image;
An X-ray image display unit for displaying the X-ray image;
Using the X-ray image, an aspiration determination device that determines that aspiration is likely to occur in the subject, and a control unit that controls imaging and processing of the fluoroscopic image,
The aspiration determination device
An area designating unit for designating a branch area where the trachea and esophagus of the subject branch in the X-ray image;
Using the X-ray image of the specified branch region, a moving region extracting unit that extracts a moving region of the test meal;
Based on the extracted moving region, a branch point detection unit for detecting a branch point of the inspection meal,
A distance determination unit that determines a distance between the branch point and an end point on the trachea side of the moving region,
The distance determination unit determines that aspiration due to the test meal is likely to occur when the distance exceeds a predetermined threshold.
X-ray fluoroscopic apparatus characterized by the above. The X-ray fluoroscopic apparatus according to claim 13,
When it is determined that aspiration due to the test meal is likely to occur, the display further includes an output unit that notifies or notifies by sound,
X-ray fluoroscopic apparatus characterized by the above. The X-ray fluoroscopic apparatus according to claim 14,
The moving region extraction unit includes:
The inter-frame difference of the brightness value in the branch area of the current frame, the previous frame, and the previous frame of the X-ray image is calculated, and the moving area is extracted using the inter-frame difference. And
The branch point detector
Thinning the moving area to obtain a moving area thin line,
The distance determination unit
The length from the branch point to the end point of the moving region fine line on the trachea side is the distance.
X-ray fluoroscopic apparatus characterized by the above.

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